Agra: In the six months since the Uttar Pradesh government introduced free Tissue Plasminogen Activator (TPA) injection, which otherwise cost Rs 48,500, in 18 district hospitals to treat brain stroke patients, not one person has been administered the life-saving drug. The districts include Agra, Ghaziabad, Azamgarh, Kanpur, Lucknow, Jhansi, Raebareli and Bareilly.

While sources claim that the main reason for this has been the government's failure to publicize the availability of the injection, which can be a lifesaver in many cases. Uttar Pradesh principal secretary (health) Arvind Kumar said that the drug is only effective, if it is administered within four hours of the stroke and patients generally arrive at the district hospital quite late.

"People are generally not aware about the crucial four-hour window for the administration of the drug. This injection, which breakdowns clots and improves blood circulation to the brain in the event of a stroke, would only be effective if administered within that crucial time frame," Kumar said.

Agra District hospital's Dr Piyush Jain, who is also part of the newly formed stroke response team, said: "Only timely action can minimize the impact of stroke and if the injection administered within three to four hours, it will be possible to restore the patient's mobility." He added that TPA can be administered only to patients suffering from a particular type of brain stroke called ischemic stroke. Patients suffer an ischemic stroke when the blood supply to the brain is cut off because of a clot. However, in cases of haemorrhagic stroke, which results from the rupturing of blood vessels, TPA cannot be administered.

Admitting that more public awareness needed to be generated about the benefits of the injection, Dr Jain said: "A campaign to this effect will launched soon. It will be called 'FAST' - Facial affect, Arm weakness, Speech problem, and Time of stroke - and will help the public identify brain stroke patients. This will ensure timely help is provided for affected patients." A health department official admitted: "Many within our own department don't know about the availability of this treatment. How can the government expect people to know when there has been no publicity for it."

According to reports, stroke is the third most common "killer" in India after cardiac ailments and cancer. According to National Centre for Biotechnology, an estimated 1.6 million people in India suffer strokes every year. Experts say that in nearly 80% of stroke cases, death or paralysis can be prevented if symptoms are identified and the patient is treated promptly within the four hour window.

UP National health Mission DGM Amresh Singh, said: "In the first phase, around 40 doctors have been trained in 18 district hospitals, where CT scan facility and radiologists are available. The state government would try to cover 22 more districts by the end of this year and a proposal has been sent to the Union government for a sanction of Rs 7.8 crores to this end."